Abstract
Abstract Health inequalities have been consistently reported across and within European countries and continue to pose major challenges to policy-making. In the EURO-HEALTHY project, funded by Horizon 2020, three 2030 time-horizon scenarios were developed, depicting the key factors that may affect the evolution of PH inequalities across European regions. A three-stage socio-technical approach was applied: i) identification of drivers (key factors expected to affect the evolution of PH inequalities across European regions until 2030) - this stage engaged in a Web-Delphi process a multidisciplinary panel of 51 experts and other stakeholders representing the different perspectives regarding PH inequalities; ii) generation of scenario structures - different drivers' configurations (i.e. their hypotheses for evolution) were organised into coherent scenarios using the Extreme-World Method; and iii) validation of scenario structures and generation of scenario narratives. Stages ii) and iii) were conducted in two workshops with a strategic group of 13 experts with a comprehensive view about PH inequalities. Three scenarios were developed for the evolution of PH inequalities in Europe until 2030: 'Failing Europe' (worst-case but plausible scenario), 'Sustainable Prosperity' (best-case), and an interim scenario 'Being Stuck' depicting a 'to the best of our knowledge' evolution. These scenarios show the extent to which a combination of Political, Economic, Social, Technological, Legal and Environmental drivers shape future health inequalities, providing information for European policy-makers to reflect upon whether and how to design robust policy solutions to tackle PH inequalities. The work presented owes its innovation to the use of a technological platform to interact with participants for idea-generation, together with the use of future-oriented evidence within a face-to-face environment to trigger discussion among a small strategic group to enrich the scenario narratives.
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